Provider Demographics
NPI:1629892559
Name:AMERICROSS TRANSPORT
Entity type:Organization
Organization Name:AMERICROSS TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANNON
Authorized Official - Middle Name:BLAKE
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-996-3284
Mailing Address - Street 1:7024 CLARKE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76135-1604
Mailing Address - Country:US
Mailing Address - Phone:817-996-3284
Mailing Address - Fax:
Practice Address - Street 1:7024 CLARKE DR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:TX
Practice Address - Zip Code:76135-1604
Practice Address - Country:US
Practice Address - Phone:817-996-3284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)